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Original Research: COPD |

Chronic Renal Failure: A Neglected Comorbidity of COPD

Raffaele Antonelli Incalzi, MD; Andrea Corsonello, MD; Claudio Pedone, MD; Salvatore Battaglia, MD; Giuseppe Paglino, MD; Vincenzo Bellia, MD, FCCP; on behalf of the Extrapulmonary Consequences of COPD in the Elderly Study Investigators *
Author and Funding Information

From the Cattedra di Geriatria (Drs Antonelli Incalzi and Pedone), University Campus BioMedico, Rome; the Fondazione San Raffaele (Dr Antonelli Incalzi), Cittadella della Carità, Taranto; the Istituto Nazionale di Ricovero e Cura per Anziani (Dr Corsonello), Cosenza; the Fondazione Alberto Sordi Onlus (Dr Pedone), Rome; and the Dipartimento di Medicina, Pneumologia, Fisiologia e Nutrizione Umana (Drs Battaglia, Paglino, and Bellia), University of Palermo, Palermo, Italy.

Correspondence to: Andrea Corsonello, MD, Istituto Nazionale di Ricovero e Cura per Anziani, C.da Muoio Piccolo, I-87100 Cosenza, Italy; e-mail: andrea_corsonello@tin.it

A complete list of study participants is located in the Appendix.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(4):831-837. doi:10.1378/chest.09-1710
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Background:  To the best of our knowledge, the association between COPD and chronic renal failure (CRF) has never been assessed. Lean mass is frequently reduced in COPD, and the glomerular filtration rate (GFR) might be depressed in spite of normal serum creatinine (concealed CRF). We investigated the prevalence and correlates of both concealed and overt CRF in elderly patients with COPD.

Methods:  We evaluated 356 consecutive elderly outpatients with COPD enrolled in the Extrapulmonary Consequences of COPD in the Elderly Study and 290 age-matched outpatients free from COPD. The GFR was estimated using the Modification of Diet in Renal Disease Study Group equation. Patients were categorized as having normal renal function (GFR ≥ 60 mL/min/1.73 m2), concealed CRF (normal serum creatinine and reduced GFR), or overt CRF (increased serum creatinine and reduced GFR). Independent correlates of CRF were investigated by logistic regression analysis.

Results:  The prevalence of concealed and overt CRF in patients with COPD was 20.8% and 22.2%, respectively. Corresponding figures in controls were 10.0% and 13.4%, respectively. COPD and age were significantly associated with both concealed CRF (COPD: odds ratio [OR] = 2.19, 95% CI = 1.17-4.12; age: OR = 1.06, 95% CI = 1.04-1.09) and overt CRF (COPD: OR = 1.94, 95% CI = 1.01-4.66; age: OR = 1.06, 95% CI = 1.04-1.10). Diabetes (OR = 1.96, 95% CI = 1.02-3.76), hypoalbuminemia (OR = 2.83, 95% CI = 1.70-4.73), and muscle-skeletal diseases (OR = 1.78, 95% CI = 1.01-3.16) were significant correlates of concealed CRF. BMI (OR = 1.05, 95% CI = 1.01-1.10) and diabetes (OR = 2.25, 95% CI = 1.26-4.03) were significantly associated with overt CRF.

Conclusions:  CRF is highly prevalent in patients with COPD, even with normal serum creatinine, and might contribute to explaining selected conditions such as anemia that are frequent complications of COPD.


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